- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,890.45 / $10,471.29
| Facility | | $1,000.00 | $3,890.45 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,041.74 / $3,235.94
| Facility | | $1,949.84 | $2,041.74 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $8,709.64 / $8,709.64
| Facility | | $501.19 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,122.02 / $12,882.50
| Facility | | $676.08 | $1,122.02 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,623.41 / $10,715.19
| Facility | | $2,398.83 | $5,623.41 | $10,715.19 |